URINE EXAMINATIONS

• PHYSICAL EXAMINATION OF URINE

  • color
  • clarity
  • volume
  • odor
• NORMAL URINE COLOR

  • Pale yellow
  • yellow
• ABNORMAL URINE COLOR

  • Dark Yellow or Amber
  • Yellow-orange
  • Red
  • Brown Urine containing Blood
  • Brown or black
  • Blue / Green
• Dark Yellow or Amber – presence of the abnormal

  pigment bilirubin
• Yellow-orange - administration of phenazopyridine (pyridium) or azogantrisin compounds to persons with urinary tract infections
• Red – presence of blood
• Brown Urine containing Blood – glomerular bleeding
• Brown or black – melanin or homogentisic acid, levodopa, methyldopa, phenol derivatives, and metronidazole (Flagyl)
• Blue / Green – bacterial infections, including urinary tract infection by Pseudomonas species and intestinal tract infections resulting in increased urinary indican
• URINE CLARITY

  • Clear
  • Hazy
  • Cloudy
  • Turbid
  • Milky
• Clear - No visible particulates, transparent
• Hazy - few particulates, print easily seen through urine
• Cloudy - many particulates, print blurres through urine
• Turbid - print cannot be seen through urine
• Milky - many precipitate or be clotted
• Aromatic - normal odor
• Foul, ammonia-like - bacterial decomposition, urinary tract infection
• Fruity sweet - Ketones (diabetes mellitus, starvation, vomiting)
• Maple syrus - maple syrup urine disease
• Mousy - phenylketonuria
• Rancid - tyrosinemia
• Sweaty feet - Isovaleric acidemia
• Cabbage - methionine malabsorption
• Bleach - contamination
• Reagent strip - A color-producing chemical reaction takes place when the absorbent pad comes in contact with urine
• pH - Aid in determining the existence of systemic acid-base disorders of metabolic or respiratory origin
• PROTEIN - Most indicative of renal disease
• Normal urine - <10 mg/dL or 100 mg per 24 hrs
• Clinical proteinuria - > 30 mg/dL (300 mg/L)
• KETONES - Represents three intermediate products of fat

  metabolisms:

  • Acetone
  • Acetoacetic acid
  • Beta-hydroxybutyric acid
• KETONURIA

  • Shows a deficiency in insulin, indicating the need to regulate dosage

  • It is often an early indicator of insufficient insulin dosage in type 1 diabetes and in patients with diabetes who experience medical problems in addition to diabetes
• BLOOD - May be present in the urine either in the form of intact red blood cells (hematuria) or as the product of blood cell destruction, hemoglobin
• BILIRUBIN

  • An early indication of liver disease

  • Often detected long before the development of jaundice
• UROBILINOGEN - Circulates in the blood en route to the liver, it passes through the kidney and is filtered by the glomerulus
• NITRITE

  • Provides a rapid screening test for the presence of urinary tract infection (UTI)

  • Valuable for detecting initial bladder infection (cystitis)
• LEUKOCYTE ESTERASE - More standardized means for the detection of leukocytes
• SPECIFIC GRAVITY

  • Measures only ionic solutes

  • Eliminating the interference by the large organic molecules, such as urea and glucose, and by radiographic contrast media and plasma expanders that are included in physical measurements of specific gravity
• Bilirubin and Glucose – 30 seconds after dipping in the urine
• Ketone and Ascorbate – 40s
• Specific gravity – 45s